Medical Waste Handling 101

Medical waste handling processes vary from state to state, but it’s important to know how to differentiate between different categories of medical waste in order to be able to properly segregate and dispose of them. In general, anything that has come into contact with blood or body fluids (such as soiled dressings, sponges, drapes, lavage tubes, drainage sets, under-pads, and surgical gloves) falls under the category of infectious medical waste. As for the specifics, medical waste categories can, for the most part, be broken down into the following seven types.

1) Cultures and Stocks

What it is:

Infectious agents and associated biologicals, including cultures from medical and pathological laboratories; cultures and stocks of infectious agents from research and industrial laboratories; waste from the production of biologicals; discarded live and attenuated vaccines; and culture dishes and devices used to transfer, inoculate, and mix cultures.

What’s done with it:

Cultures and stocks can be packaged for disposal by an outside contractor. Although states do not require it, many hospitals implement a policy of autoclaving this type of medical waste in the laboratory itself, out of fear that these highly-infectious specimens are more liable to cause infections to their handlers in the event of inadvertent exposure.

2) Human Blood and Blood Products

What it is:

Waste blood, serum, plasma and blood products.

What’s done with it:

This material can be packaged for disposal by an outside contractor. Although states do not require it, many hospitals implement a policy of autoclaving this type of medical waste depending on where it is generated, out of fear that these highly-infectious materials are more liable to cause infections to their handlers in the event of inadvertent exposure.

3) Pathological Waste

What it is:

Pathological waste includes tissues, organs, body parts, and body fluids removed during surgery and autopsy. From a microbiological standpoint, this type of material is not really different from cultures and stocks; but from a waste management standpoint, the States may require other management conditions.

What’s done with it:

Pathological wastes are always packaged separately for disposal, and typically incinerated. Some medical waste disposal companies have received approval for a ‘greener’ solution which entails sanitizing pathological waste through microwaves, after which the treated waste may be disposed of as ordinary solid waste in a waste-to-energy plant or landfill.

Chemotherapeutic wastes are drugs or agents utilized in chemotherapy and considered hazardous waste by USEPA-RCRA. These are generally categorized by the EPA as P or U-listed wastes.

What’s done with it:

Due to its highly toxic nature, chemotherapy waste gets segregated in its own containers, with different labeling and colors so that it doesn’t get mixed up with the general medical waste. This type of waste must be packaged in DOT approved containers, and removed by a hazardous waste disposal company (as opposed to a standard medical waste disposal company), after which it is generally incinerated.

6) Trace Chemotherapy Waste

What it is:

Trace chemotherapy waste includes items that have been used in administering chemotherapy (such as needles, syringes, etc.), and have come into contact with chemotherapy agents.

What’s done with it:

These items may be classified as regulated medical waste or as hazardous medical waste, depending on the type of chemical with which they have come into contact. If the chemotherapy agent was a U-listed waste and the container meets the EPA’s empty container rule, the EPA considers trace chemotherapy articles to be regulated medical waste; however, if the chemotherapy agent was a P-listed waste, the item would have to be segregated as regulated hazardous waste (RCRA waste) and disposed of as such.

7) Isolation Waste

What it is:

Medical waste that has come into contact with a highly contagious or dangerous infectious disease – such as tuberculosis or ebola, which receives a Level 4 biomedical waste safety designation for handling as a DOT Div. 6.2 Category A Infectious substance

What’s done with it:

Different facilities maintain differing policies when it comes to the segregation and storage of isolation waste; but in general, the goal is to keep it separate so as to avoid the risk of infection. For instance, some facilities may mandate autoclaving on hospital premises, or separate packaging and containers.